Monitoring your mental health

Living with a long-term health condition such as pulmonary hypertension can leave you more susceptible to mental illnesses like depression and anxiety. Here, Psychological Wellbeing Practitioner Philippa Horn, who has PH herself, calls on patients to seek help when they need it.

“Our physical and
emotional health are equal and intertwined components of wellbeing.

Research shows that
people with long term health conditions are twice as likely to have depression. It
also shows that when people have depression they are less likely to look after
themselves properly, and less likely to comply with their specialist care plan
– which in turn will lead to increased personal distress, and deterioration in
physical health.

When people have
depression, they may isolate themselves from other people because they might
feel they cannot be bothered, it is too much effort, or there is nothing apart
from illness to talk about.

Phillipa Horn

When we avoid people,
we are missing out on an opportunity to have fun, and there may be a tendency
to fill the time instead by worrying about our health conditions, and focusing
on negative thoughts. If we constantly avoid our friends we can lose
friendships, which is something I frequently hear in my work.

Anxiety may also be an
issue, and for those with more than one long-term health condition, this can be
exacerbated.

It is therefore vital
that all PH patients keep an eye on their mental health and get help when they
need it.
An individual’s view
of both physical and mental illness will be influenced by their family culture,
how they were brought up and memories of loved ones. But depression, anxiety
and panic disorder are very treatable conditions, so please do not allow any
possible perceived stigma of mental health to prevent you from accessing
services. Treatment is delivered in a variety of formats nowadays – face
to face, in groups, over the telephone or using technology, for example a
computer package.

Accessing support

My story

By Phillipa Horn

At the time of being diagnosed with PH in 2009, I worked part-time in administration for the NHS and was part way through a counselling diploma. I returned to work on a phased return seven months later, and off I would go to work with my packed lunch and oxygen cylinder. I managed to complete my counselling diploma the following year. In October 2015, I got a job as a trainee Psychological Wellbeing Practitioner, a golden opportunity. I was required to work full time and attend university two days a week and complete academic study. This was a huge challenge for me, working full time after working part time for 27 years. I knew that I was stretching myself physically and academically, but if I wanted a more rewarding job, I needed to take the risk and try. Fortunately, I passed the course in October 2016 and secured a full-time post as a psychological wellbeing practitioner. This is a job I love. I spend my time doing assessments for people to consider if they are suitable for services and delivering low intensity cognitive behavioural therapy treatments. I have also recently completed additional training in long term health conditions.I do enjoy the challenge of learning and want to help people who have PH assess their mental health.

If you have concerns
about your mental health, the first step is to visit your GP. Quite often, they will suggest you contact your
local Improving Access to Psychological Therapies (IAPT) service for an
assessment. Improving Access to Psychological Therapies is an NHS (England)
initiative to provide more psychotherapy to the general population.

Any person can contact
their local mental health team via telephone or online, so if you would prefer
to self-refer, instead of going via your GP, this is an option.

Depending on where you
live, they might be called a Wellbeing Team, Mental Health Matters, Healthy
Minds, or a different name entirely.

Once you have contacted
them, after giving some demographic details, you will be booked in for an
assessment. These are mostly done over the telephone, although face-to-face assessments
are available if you have a hearing impairment.

During the call, you
will be asked to complete standard questionnaires which measure symptoms of low
mood and anxiety (known as PHQ-9 and GAD-7). Some of the questions will be
around risk to yourself, so don’t be alarmed by this. Everything you say in the
assessment is confidential (unless there are concerns about risks to yourself
or others) and the call usually takes about 45 minutes.

You will be asked to
describe what your main problem is and what it is that you would like some help
with. Some people do get upset when having their assessment – you are only
human so please do not be embarrassed; the person carrying out the assessment
will be caring and experienced.

At the end of the
assessment, you will jointly decide what is the best treatment available. It
might be counselling, cognitive behaviour therapy (CBT) or guided self-help –
which is psycho education about low mood, unhelpful thinking habits we can
have, relaxation, increasing your activities, worry management, anxiety and
sleep.

Symptoms

According to the NHS, symptoms of DEPRESSION can include continuous low mood or sadness, feeling hopeless and helpless, low self-esteem, feeling tearful, guilt-ridden, irritable, and having difficulty making decisions. Physical symptoms may include a change in appetite, disturbed sleep, loss of libido and lack of energy. Symptoms of ANXIETY can include restlessness, a sense of dread, feeling constantly “on edge”, difficulty concentrating, irritability, feeling sick and insomnia. Visit www.nhs.uk for the full list of symptoms.

Some geographical areas
run groups specifically for people who have long term health conditions, which
include topics such as pain management, and pacing.

Most areas run groups for anxiety and depression, which are education based. Do not feel that it is ‘group therapy’ – it is all about learning techniques for coping and learning what maintains cycles of depression or anxiety. On a day-to-day basis we can do things ourselves to enhance our feelings of wellbeing. This includes eating well, as this affects our physical health and emotional health, exercising, getting out of the house, seeing friends and connecting with other people. Setting goals, however small, can help and remember – confidence does not develop through thinking alone; we need to do things to develop it.”

Members of the PHA UK have access to a free, dedicated helpline and email service run by Anxiety UK. If you or your family have concerns about your emotional wellbeing, call 0844 332 9010 or email phauk@anxietyuk.org.uk. See p46 for further details.

We are appreciative to Actelion Pharmaceuticals UK Ltd for an unrestricted grant to support the structure of this website. Actelion Pharmaceuticals Ltd have had no input into the contents of the website, which remains copyright to the PHA UK.